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Albinni B, Zimmerman M, Ross J, Ozdoyuran L, Alasha V, Schuster NM, Said E, Case L. Subcutaneous Oxytocin Injection Reduces Heat Pain: A Randomized-Controlled Trial. J Pain 2024:104547. [PMID: 38642595 DOI: 10.1016/j.jpain.2024.104547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
Oxytocin (OT) is a neuropeptide broadly implicated in social relationships and behavior. OT also exerts antinociceptive and pain-reducing effects in both humans and rodents. Recent research in rodents demonstrates that these effects can be peripheral and local. In human studies, intravenous OT has reduced visceral pain, and subcutaneous injection of OT has reduced postsurgical pain. However, the local effects of subcutaneous OT on experimental pain have not been studied. We conducted a 2-session crossover study during which healthy adults received a subcutaneous injection of synthetic OT (4 mcg/2 mL) or saline placebo (isotonic saline 2 mL), in a randomized and double-blinded manner. Eighteen participants completed full study procedures. We hypothesized that 10 minutes after injection, OT would reduce measures of acute mechanical pain, pressure pain, and heat pain perception. Subcutaneous OT significantly reduced ratings of heat pain intensity and unpleasantness (both P < .01), but did not alter mechanical pain, pressure pain, or heat pain threshold (all P > .05). Changes in heat pain were observed only on the injected arm and not on the contralateral arm, confirming a localized mechanism. These findings confirm the ability of OT in or near the skin to modulate nociceptive processes in cutaneous tissues in human adults, opening exciting avenues for further mechanistic research as well as potential clinical applications for acute pain. PERSPECTIVE: This randomized-controlled trial showed that a subcutaneous injection of OT could reduce perception of heat pain tested with a thermode. OT did not alter mechanical or pressure pain or thresholds for perceiving heat pain. These findings are relevant to scientists and clinicians seeking nonaddictive local drug treatments for pain.
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Affiliation(s)
- Benedetta Albinni
- Department of Anesthesiology, UC San Diego Health, La Jolla, California
| | - Marisa Zimmerman
- Department of Anesthesiology, UC San Diego Health, La Jolla, California
| | - Jacob Ross
- Department of Anesthesiology, UC San Diego Health, La Jolla, California
| | - Leyla Ozdoyuran
- Department of Anesthesiology, UC San Diego Health, La Jolla, California
| | - Vincent Alasha
- Department of Anesthesiology, UC San Diego Health, La Jolla, California
| | | | - Engy Said
- Department of Anesthesiology, UC San Diego Health, La Jolla, California
| | - Laura Case
- Department of Anesthesiology, UC San Diego Health, La Jolla, California; VA San Diego Healthcare System, San Diego, California.
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Huang Y, Lin Q, Tan X, Jia L, Li H, Zhu Z, Fu C, Wang L, Liu L, Mao M, Yi Z, Ma D, Li X. Rehmannia alcohol extract inhibits neuropeptide secretion and alleviates osteoarthritis pain through cartilage protection. Heliyon 2023; 9:e19322. [PMID: 37674829 PMCID: PMC10477487 DOI: 10.1016/j.heliyon.2023.e19322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/13/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023] Open
Abstract
Osteoarthritis (OA) is a common joint disease characterized by chronic pain, and the perception of pain is closely associated with brain function and neuropeptide regulation. Rehmannia is common plant herb with anti-inflammatory and analgesic properties that is used to treat OA. However, it is unclear whether Rehmannia alleviates OA-related pain via regulation of neuropeptides and brain function. We examined the pain relief regulatory pathway in OA after treatment with Rehmannia by verifying the therapeutic effect of Rehmannia alcohol extract in vivo and vitro and exploring of the potential mechanism underlying the analgesic effect of Rahmanian using functional magnetic resonance imaging and measuring neuropeptide secretion. Our results showed that Rehmannia alcohol extract and the related active ingredient, Rehmannioside D, can delay cartilage degradation and alleviate inflammation in OA rats. The Rehmannia alcohol extract can also relieve OA pain, reduce the secretion of calcitonin gene-related peptide (CGRP) and substance P (SP), and reverse the pathological changes in the cerebral cortex and hippocampus. Our research results demonstrate that Rehmannia alleviates OA pain by protecting cartilage, preventing the stimulation of inflammatory factors on neuropeptide secretion, and influencing the relevant functional areas of the brain.
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Affiliation(s)
- Yanfeng Huang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Qing Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Xue Tan
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Liangliang Jia
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Hui Li
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- College of Pharmacy Science, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Zaishi Zhu
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Changlong Fu
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Lili Wang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Linlong Liu
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
| | - Min Mao
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Zhouping Yi
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Dezun Ma
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
| | - Xihai Li
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, 350122, China
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China
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Wang X, Li JL, Wei XY, Shi GX, Zhang N, Tu JF, Yan CQ, Zhang YN, Hong YY, Yang JW, Wang LQ, Liu CZ. Psychological and neurological predictors of acupuncture effect in patients with chronic pain: a randomized controlled neuroimaging trial. Pain 2023; 164:1578-1592. [PMID: 36602299 DOI: 10.1097/j.pain.0000000000002859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
ABSTRACT Chronic pain has been one of the leading causes of disability. Acupuncture is globally used in chronic pain management. However, the efficacy of acupuncture treatment varies across patients. Identifying individual factors and developing approaches that predict medical benefits may promise important scientific and clinical applications. Here, we investigated the psychological and neurological factors collected before treatment that would determine acupuncture efficacy in knee osteoarthritis. In this neuroimaging-based randomized controlled trial, 52 patients completed a baseline assessment, 4-week acupuncture or sham-acupuncture treatment, and an assessment after treatment. The patients, magnetic resonance imaging operators, and outcome evaluators were blinded to treatment group assignment. First, we found that patients receiving acupuncture treatment showed larger pain intensity improvements compared with patients in the sham-acupuncture arm. Second, positive expectation, extraversion, and emotional attention were correlated with the magnitude of clinical improvements in the acupuncture group. Third, the identified neurological metrics encompassed striatal volumes, posterior cingulate cortex (PCC) cortical thickness, PCC/precuneus fractional amplitude of low-frequency fluctuation (fALFF), striatal fALFF, and graph-based small-worldness of the default mode network and striatum. Specifically, functional metrics predisposing patients to acupuncture improvement changed as a consequence of acupuncture treatment, whereas structural metrics remained stable. Furthermore, support vector machine models applied to the questionnaire and brain features could jointly predict acupuncture improvement with an accuracy of 81.48%. Besides, the correlations and models were not significant in the sham-acupuncture group. These results demonstrate the specific psychological, brain functional, and structural predictors of acupuncture improvement and may offer opportunities to aid clinical practices.
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Affiliation(s)
- Xu Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Jin-Ling Li
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Ya Wei
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Na Zhang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Feng Tu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Chao-Qun Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ya-Nan Zhang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Yue-Ying Hong
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Mekhael AA, Bent JE, Fawcett JM, Campbell TS, Aguirre-Camacho A, Farrell A, Rash JA. Evaluating the efficacy of oxytocin for pain management: An updated systematic review and meta-analysis of randomized clinical trials and observational studies. Can J Pain 2023; 7:2191114. [PMID: 37205278 PMCID: PMC10187080 DOI: 10.1080/24740527.2023.2191114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 02/14/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023]
Abstract
Background There is a need for novel analgesics with favorable risk to benefit profiles. Oxytocin has recently gained attention for its potential analgesic properties. Aim The aim of this study was to perform an updated systematic review and meta-analysis evaluating the effect of oxytocin for pain management. Method Ovid MEDLINE, Embase, PsycINFO, CINAHL, and Clinicaltrials.gov were searched for articles reporting on associations between oxytocin and chronic pain management from January 2012 to February 2022. Studies published before 2012 that were identified in our previous systematic review were also eligible. Risk of bias of included studies was assessed. Synthesis of results was performed using meta-analysis and narrative synthesis. Results Searches returned 2087 unique citations. In total, 14 articles were included that reported on 1504 people living with pain. Results from meta-analysis and narrative review were mixed. Meta-analysis of three studies indicated that exogenous oxytocin administration did not result in a significant reduction in pain intensity relative to placebo (N = 3; n = 95; g = 0.31; 95% confidence interval [CI] -0.10, 0.73). Narrative review provided encouraging evidence that exogenous oxytocin administration reduced pain sensitivity among individuals with back pain, abdominal pain, and migraines. Results suggested that individual difference factors (e.g., sex and chronic pain condition) may influence oxytocin-induced nociception, but the heterogeneity and limited number of studies identified precluded further investigation. Discussion There is equipoise for the benefit of oxytocin for pain management. Future studies are imperative and should undertake more precise exploration of potential confounds and mechanisms of analgesic action to clarify inconsistency in the literature.
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Affiliation(s)
- Anastasia A. Mekhael
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Jennifer E. Bent
- Division of Community Health and Humanities, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Jonathan M. Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Tavis S. Campbell
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Aldo Aguirre-Camacho
- School of Biomedical Sciences, European University of Madrid, Villaviciosa de Odón Madrid, Madrid, Spain
- Department of Psychology, Cardenal Cisneros University College, Madrid, Spain
| | - Alison Farrell
- Memorial University Libraries, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Joshua A. Rash
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
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Lopes S, Osório FDL. Effects of intranasal oxytocin on pain perception among human subjects: A systematic literature review and meta-analysis. Horm Behav 2023; 147:105282. [PMID: 36463692 DOI: 10.1016/j.yhbeh.2022.105282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Oxytocin (OXT) is a peptide hormone produced in the hypothalamus that plays a neuromodulatory role in emotion, stress, and anxiety. Due to its multidimensional role, OXT is a promising target for therapeutic interventions to treat pain. OBJECTIVE Perform a systematic literature review, followed by a meta-analysis to identify the effects of intranasal OXT on the self-perception of clinical and experimental pain among human subjects. METHOD A systematic review was conducted in the PubMed, PsycINFO, Scielo, Lilacs, and Web of Science databases, using the keywords Oxytocin, Pain, Analgesia, and Nociception. RESULTS Fifteen papers were included in the meta-analysis. None of the outcomes presented statistical significance in terms of the interventions' effect size: pain intensity (SMD = -0.02 (CI 95 %: -0.14 to 0.10; p = 0.76)) and pain unpleasantness (SMD = -0.15 (CI 95 %: -0.34 to 0.04; p = 0.12)). No meta-analysis was performed for pain threshold or tolerance because few papers address these outcomes. CONCLUSION There was no statistically significant effect of intranasal OXT administration on pain perception, considering equivalence limits between (-0.2 and 0.2). However, it must be considered that the study designs may not have been sensitive enough to detect minor analgesic effects of OXT, which, being weak, may also not be perceived at a conscious level. Additionally, OXT effects possibly depend on specific characteristics of the painful condition, such as pain complexity, intensity, and duration, contextual variables like the presence of social and affective support, and individual characteristics.
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Affiliation(s)
- Samuel Lopes
- Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Flávia de Lima Osório
- Ribeirão Preto Medical School, University of São Paulo, Brazil; National Institute for Science and Technology (INCT-TM, CNPq), Brazil.
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Bharadwaj VN, Tzabazis AZ, Klukinov M, Manering NA, Yeomans DC. Intranasal Administration for Pain: Oxytocin and Other Polypeptides. Pharmaceutics 2021; 13:1088. [PMID: 34371778 DOI: 10.3390/pharmaceutics13071088] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Pain, particularly chronic pain, remains one of the most debilitating and difficult-to-treat conditions in medicine. Chronic pain is difficult to treat, in part because it is associated with plastic changes in the peripheral and central nervous systems. Polypeptides are linear organic polymers that are highly selective molecules for neurotransmitter and other nervous system receptors sites, including those associated with pain and analgesia, and so have tremendous potential in pain therapeutics. However, delivery of polypeptides to the nervous system is largely limited due to rapid degradation within the peripheral circulation as well as the blood–brain barrier. One strategy that has been shown to be successful in nervous system deposition of polypeptides is intranasal (IN) delivery. In this narrative review, we discuss the delivery of polypeptides to the peripheral and central nervous systems following IN administration. We briefly discuss the mechanism of delivery via the nasal–cerebral pathway. We review recent studies that demonstrate that polypeptides such as oxytocin, delivered IN, not only reach key pain-modulating regions in the nervous system but, in doing so, evoke significant analgesic effects. IN administration of polypeptides has tremendous potential to provide a non-invasive, rapid and effective method of delivery to the nervous system for chronic pain treatment and management.
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Zhu J, Li Y, Liang J, Li J, Huang K, Li J, Liu C. The neuroprotective effect of oxytocin on vincristine-induced neurotoxicity in mice. Toxicol Lett 2021; 340:67-76. [PMID: 33429010 DOI: 10.1016/j.toxlet.2021.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/01/2020] [Accepted: 01/04/2021] [Indexed: 02/07/2023]
Abstract
Vincristine (VCR) is commonly used to treat a variety of hematological malignancies and solid tumors in pediatric and adult patients. However, peripheral neuropathy is a dose-limiting side effect that leaves some patients with functional disability and long-term pain. Oxytocin (OT) has demonstrated analgesic and anti-inflammatory properties, but there is no evidence regarding its effects on VCR-induced neurotoxicity. Therefore, we evaluated the potential protective effects of OT on VCR-induced neurotoxicity. In vitro, VCR (0.005 ∼ 0.1 μmol/l) and OT (10-8 ∼ 10-5 mol/l) were added into cultured primary dorsal root ganglion (DRG) neurons of mice. The length of neurites was counted by using immunofluorescence. In vivo, neurotoxicity was induced in mice by administration of VCR (0.1 mg/kg, intraperitoneal injection for 14 days) with or without pretreatment of OT (0.1 mg/kg or 1 mg/kg). Atosiban, an OT receptor (OTR) antagonist and OTR knockout (KO) mice were used for evaluating effects of OTR. Mechanical hyperalgesia was measured by using von Frey filaments. Histology of plantar skin, sciatic nerve and DRG was observed by using transmission electron microscopy (TEM) and hematoxylin-eosin (HE) staining. Results indicated that OT alleviated VCR-induced neurite damage in cultured primary DRG neurons in vitro. In vivo, OT ameliorated VCR-induced hyperalgesia. Histologically, OT attenuated the VCR-induced damages of nerve endings, myelin sheaths and Schwann cells in sciatic nerve and DRG. These effects were antagonized by atosiban. In addition, OTR knockout mice exhibited more severe hyperalgesia than wild-type mice. Globally, these results indicated that OT may have neuroprotective effects on vincristine-induced neurotoxicity in mice.
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Affiliation(s)
- Jianchun Zhu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Yang Li
- Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Jinghui Liang
- Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Jingxin Li
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China
| | - Kai Huang
- Department of Oncology, Shandong University Qilu Hospital, Jinan, Shandong, PR China
| | - Jing Li
- Department of Pathology, Zibo Central Hospital, Zibo, Shandong, PR China
| | - Chuanyong Liu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, PR China.
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